| NPI | 1700424603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2023-03-27 |